BETHANY COVENANT CHURCH PERMISSION SLIP HighLight Plus: Photo Scavenger Hunt Saturday October 22, 2011

My child, has permission to attend the Photo Scavenger Hunt at Mall of New Hampshire and return to Bethany Covenant Church following the Scavenger Hunt I understand that every effort will be made to protect and safeguard all participants. Therefore, I agree not to hold Bethany Church or any of its staff and chaperones liable for any illness or mishap occurring during the event. I understand that adult supervision is being provided for the event and I authorize any treatment by an accredited hospital and/or physician if it is deemed necessary for my child. I understand I will be responsible for picking up my child at any time if my child becomes unruly. Parent/Guardian signature (date) phone

Return the upper portion of this form to Steve the day of the event
Keep this Information

If you need to get in touch with your child, you may reach them at the following number 603.325.3157 (Steves Cell)

Medical Release Form

Bethany Covenant Church wants to assure you and your child that they will receive the best possible care in the event of an accident. We would like to have a copy of any medical conditions or awareness that would benefit us in treating your child either in route to or from our excursion. This form will be with Bethany counselors at all times and will be used to help treat your student should a need for treatment arise. I authorize any treatment by an accredited hospital and or physician if it is deemed necessary for my child. Parent/ Guardian Signature_______________________________________________ Students name_________________________________________________________________ Chronic health problems/Allergies:__________________________________________ _____________________________________________________________________ Special medications used:________________________________________________ _____________________________________________________________________ Medical Insurance Company______________________Phone Number____________ Policy Number____________________________________ Parent or legal guardian contacted in case of an emergency:_____________________ Phone number:________________________________ I want to emphasize the importance we are placing on your childs safety and well being. In the event of an emergency we want your child to receive the best and quickest health care possible.